How do I know if I or my parent qualifies for government-funded aged care?

How do I know if I or my parent qualifies for government-funded aged care?

Eligibility for government-funded aged care is based mainly on age and assessed support needs.

You or your parent may qualify for an assessment if the person:

• is aged 65 or older

• is an Aboriginal or Torres Strait Islander person aged 50 or older

• is aged 50 or older and homeless or at risk of homelessness

• has started needing help with everyday activities because of ageing, illness, reduced mobility or changes in memory and thinking.

Meeting the age requirement does not automatically mean services will be approved. A government-funded aged care assessment is used to determine whether support is needed and which services or programs are appropriate.

What kinds of difficulties may indicate eligibility?

It may be worth applying for an assessment if the person is having increasing difficulty with:

• showering, dressing or personal care

• preparing meals and eating well

• cleaning, laundry or household tasks

• shopping or getting to appointments

• walking, transferring or safely moving around the home

• taking medication correctly

• recovering after a hospital admission

• remembering appointments or managing everyday routines

• remaining socially connected

• giving an unpaid family carer adequate respite.

Other common triggers include a recent fall, reduced mobility, a new medical condition, worsening dementia symptoms or a change in the amount of help family members can provide.

A person does not need to be unable to cope or require full-time care. Government-funded support may be approved for relatively limited assistance that helps the person remain safe and independent at home.

Does the person need a diagnosis?

Not necessarily.

Eligibility is based on how the person’s health and circumstances affect everyday life, rather than on having a particular diagnosis.

A person may qualify because of frailty, reduced mobility, falls risk, memory changes or difficulty completing daily tasks, even without a single diagnosed condition.

Similarly, having a diagnosis such as dementia, arthritis or Parkinson’s disease does not automatically guarantee a particular level of funding. The assessor considers the person’s actual needs, abilities, risks, goals and existing support.

Do income and assets determine eligibility?

Income and assets generally do not decide whether someone is eligible for an aged care assessment or approved services.

Financial circumstances can affect how much the person contributes towards some services after they are approved. For example, Support at Home contribution rates vary according to the service category and the financial assessment completed by Services Australia.

A person should therefore not assume they are ineligible simply because they own their home, receive a part pension or are self-funded. Eligibility and personal contributions are separate questions.

How is eligibility assessed?

The first step is to apply through My Aged Care. The person can:

• apply online

• call My Aged Care on 1800 200 422

• ask a doctor, hospital or health professional to make a referral

• seek assistance through an Aged Care Specialist Officer at a participating Services Australia location.

My Aged Care will ask some initial questions and refer the person to an assessment organisation where appropriate.

During the assessment, the assessor may ask about:

• what the person can do independently

• which tasks have become difficult or unsafe

• medical conditions and medications

• mobility, falls and home safety

• memory, communication and decision-making

• family, social and cultural circumstances

• current help from family, friends or other services

• the person’s goals and preferences.

The assessment may result in approval for Support at Home, residential respite, permanent residential aged care or another form of assistance, depending on the person’s needs. Eligibility for Australian Government-subsidised aged care is determined through the Single Assessment System.

Practical example

An 82-year-old person may still cook simple meals and manage personal care but may be struggling with cleaning, shopping, transport and safely getting in and out of the shower.

They do not need to wait until they have a serious fall or can no longer live alone. These changes may be enough to justify applying for an assessment.

The assessment might identify a need for services such as:

• domestic assistance

• transport

• meal preparation

• an occupational therapy assessment

• minor home modifications

• physiotherapy or falls-prevention support.

The exact services and level of funding would depend on the assessment outcome.

What if the person is under 65?

Government-funded aged care is generally intended for older people. A person under 65 with disability-related support needs may need to explore the National Disability Insurance Scheme or other health and community services instead. Different arrangements may apply for Aboriginal and Torres Strait Islander people and people who are homeless or at risk of homelessness from age 50.

The simplest rule is: if age requirements are met and everyday tasks are becoming harder, apply for an assessment. There is no need to work out the person’s exact eligibility before contacting My Aged Care, that is what the assessment process is designed to determine.

What should I do next?

Confirm the details with My Aged Care or the relevant provider, write down your questions and ask for important information in writing before making a decision.

Helpful Local Home Help resources

• Start with Liz

• Signs an older person may need help at home

• More articles about home care